Arab Board Urology Clinical Exam Practice Questions - Arab Board Of Health Specializations Urology Final Clinical And Oral Exam

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A 62-year-old male with a baseline PSA of 6.8 ng/mL undergoes multiparametric MRI (mpMRI) of the prostate, which demonstrates a 14 mm PI-RADS 5 lesion in the right peripheral zone with abutment of the capsule but no gross extraprostatic extension. Targeted and systematic transperineal biopsies reveal ISUP Grade Group 2 (Gleason score 3+4=7) adenocarcinoma in 3 targeted cores (maximum core involvement 40%), and all systematic cores from the left lobe are benign. What is the most appropriate next clinical management discussion with this patient?

Immediate initiation of androgen deprivation therapy monotherapy Discussion of definitive local therapies (radical prostatectomy or external beam radiotherapy) versus carefully monitored active surveillance Immediate bilateral pelvic lymph node dissection alone as a diagnostic procedure Systemic chemotherapy with six cycles of docetaxel

Correct Answer:

Discussion of definitive local therapies (radical prostatectomy or external beam radiotherapy) versus carefully monitored active surveillance

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